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Care for patients with asthma requires prompt and effective decision-making abilities. Many nursing students report a lack of preparedness and competence with respect to their ability to perform nursing duties. Simulation-based learning has been developed as a potential solution to this problem. Moreover, the simulation scenario with an evaluation checklist offers a reliable evaluation strategy for the education and training of clinical decision-making skills among nursing students. The simulation scenario and evaluation checklist developed in this study offer a means to improve patient safety during asthma care in the emergency care unit, as well as to improve nursing students’ problem-solving competencies and communication with patients with asthma.